Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YS0123X | Facial Plastic Surgeon | 01069139A | IN |
N | 207YS0123X | Facial Plastic Surgeon | 125.051605 | IL |
Y | 207YS0123X | Facial Plastic Surgeon | P2101 | TX |
NPI | 1659520906 |
---|---|
Provider Name | Dr. Robert William Brobst JR. |
First Address | Plano, TX 75024-2403 |
Second Address | Plano, TX 75024-2403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2008 |
Last Update Date | 27/07/2012 |